Healthcare Provider Details
I. General information
NPI: 1023805314
Provider Name (Legal Business Name): LORI ANN HILLOCK PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/22/2025
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 MEDICAL CENTER PKWY
AUGUSTA ME
04330-8160
US
IV. Provider business mailing address
35 MEDICAL CENTER PKWY
AUGUSTA ME
04330-8160
US
V. Phone/Fax
- Phone: 207-248-0050
- Fax: 207-861-5233
- Phone: 207-248-0050
- Fax: 207-861-5233
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | CNP251236 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: